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1rT-14-2004 16:09 From: 18884976250 640138 P.111 <br /> . CHO LOC NUMBER <br /> CATO W ICOM, SAN JOA4UIN COUNTY <br /> F1 <br /> CNV'IT.t.ONMMNTAL HEALTH DEPARTMENT <br /> 13 <br /> 304 Weber Ave 3"1 Floor Stnakton001,CA 95205 107 <br /> i <br /> OCT 14 2Qb9)468-3420 Fax: (209)464-0138 Web.wWW-CO.eaa joaqu41'Ca.ue/ohd <br /> ENVIRON v"t i i iiLA TH PUBLIC RECORDS RELEASE APPLICATION <br /> A"LIGa T: N N u aUSWC651AGCHCY: 950 <br /> ADD0156: Mrsc/o/� Co e B/'✓D °R'�S �g 9�7-6o7-S� <br /> PHONE: $ 9S-S PADSIMILE: <br /> TENITATWAPPOxNWWRNTPATE: I0 0 Time:a <br /> (PINu&UQW 10&Wines drys k.M dots el sppaallon submtaall <br /> CHSCK aOx TO gMorM RSQUE6T•$93.0e Fer-IWQUM PH SSCP IN 3 RUSINW$DAYS <br /> SIGNATURE OF APPLICANT r / DATE <br /> r O.Wnmsnt Uee Only <br /> FILM AODRRSB UNIT[] Unll 1 <br /> 09145 <br /> Von on e Unit 8 p\VS <br /> r <br /> Un%4 <br /> (] Unit 6 <br /> e <br /> ENVIRONMENTAL HEALTH DEPARTMENT PILES J,)1101.10 WA= {��►\� V <br /> UNDBROROUNO TANK(USM CLEANUP BRE tLOP) (7 HOUMNO AOATFUINT 0 60UP WAM WHICLR <br /> OTHRR CLEANUP arr8(NON4JOP) E3 rOOD FA0AJTY <br /> UNOfiROROUNO TANK(MONfI'Opa1GIREMOYAy Co o0G KENNEL 0 DAIRY <br /> 0 HAzARDM WATM d6NCRATOR 0 CHICKEN RANCH C PKG TRSATYcWCNT PLANT <br /> 4 TIaRse,PERMn MI)FACILITY G MOTELMOT61 13 PUMP&R TRUCKIYARo/CHaM TOIL,L'Ta <br /> E3 TATTOOlDOOY PIERCING C7 POOLRIPA .17SLAN 11 tlAPa 41CAT10N ORLa <br /> ❑ MaDICAL WASTC FACILITY ,�Q OTHER(PLL&Ad aP110",,,., ('I S�'L-(-'I w1 <br /> 1. List up to tan addreaave In the spa .p above. Salpet the type(e)of fllea from the list&boyo by checking <br /> the appropriate box(es). At least o flis bo selected, r"to(loel 464 188 or melt to the <br /> ilddrevy dl n <br /> 2. PKD will notify the■ppli"m if any rria flies exist. An appointment for review will be confirmed <br /> approximately flea buslneas days but no later than ten(10)days after receipt of application. The fibs <br /> will be held for a maximum of five business days for ravlew. Appointments should be scheduled <br /> accordingly. <br /> 8. A file that Is actively boine worked on by EHD staff may not be immediately available for review. A now <br /> application may be submitted when the file Is available. <br /> 4. Any file not returned In the same condition as roloased will be reorganized by EHO staff st the expense <br /> of the applicant. Future file revI16 by the same applicant may require a$93.00 deposit prior to review. <br /> 5. 'T'ENTAT'IVE appointment dates mlfat bu confirmed with EHD staff, <br /> 6. Appllontione rocotved after 9:00 pm,will be processed this next business day. <br /> CON FIRM EQ,APtip1 MENT GATE eaa. TIME <br /> "'PHONE FAX :.'a .tN� <br /> ,(PA'rBCONFIRMED � ;; ;;��_� �� ,.; �•*-�«s1:�' <br /> kiVMED YES NQ REVIEW DATE <br /> p&B 9JVd H.L-VZH 1V1N3*J0UXANB 69TOP99 5&197 9g0&/9t./01 <br />